Man with Down’s Syndrome died after choking on cheese roll at care home in Walcott

The family of a man with Down’s Syndrome has spoken of their devastation after he died after choking on a cheese roll at his care home.

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Paul Relton’s care plan at The Rookery home in Walcott said he needed one-to-one supervision when eating, and his food had to be cut into pieces the size of a Malteser to avoid choking.

However, an inquest yesterday heard the 45-year-old took another resident’s cheese roll after finishing his meal on October 14, 2012, and put it into his mouth.

James Dean, a support worker at the home, said he took Mr Relton out of the dining room and into the lounge so he could not take any more food. He said he did not check whether he had swallowed the roll, but Mr Relton did not appear to be in distress or have anything in his mouth.

He said after a few minutes “Paul got up off the chair and ran out of the room, and he was then in the corridor and I heard him cough.

“Paul often coughed and it just sounded like a normal Paul cough, but he carried on coughing so I went out into the corridor to check on him and he was leaning against the wall.”

He said he returned a client he was with to the lounge, and found Mr Relton lying face down on the floor in another part of the building when he came back.

After calling other staff, he rang 999 and relayed the operator’s instructions to staff performing CPR.

The inquest heard he called 999 at 5.56pm, but the first paramedics did not arrive until 6.18pm, 14 minutes longer than their target, while an ambulance did not arrive until 6.38pm, 23 minutes above target.

Mr Relton died in hospital two days later.

The care home complained to the East of England Ambulance Service, which apologised after an investigation, but coroner Jacqueline Lake said she was satisfied the delay did not cause or contribute to Mr Relton’s death.

Mr Dean said he felt more staff in the dining room may have stopped Mr Relton grabbing the roll, but the care home manager said the home’s staffing levels met its regulatory requirements.

Richard Barr, representing the Relton family, said his death was avoidable, but Michael Lemmy, representing the care home, said Mr Relton may have choked on food he had regurgitated.

The coroner recorded a verdict of accidental death, and said: “I am satisfied with the care plan which was put in place, and also that the staff on duty that day took all steps they could to help Mr Relton.”

Speaking after the inquest, Mr Relton’s sisters Kathryn Relton and Elizabeth Berman said: “Our family is devastated by the loss of our beloved Paul. He will live forever deep in our hearts.”